Porfimer

Porfimer Brand Name– Photofrin

What is Porfimer

Porfimer is a photoactivated radical generator consisting of oligomers containing porphyrin.

Photodynamic therapy (PDT) with porfimer is a 2-stage process involving intravenous administration of porfimer, followed by administration of a 630 nm wavelength laser light.

It is indicated for the palliative treatment of patients with partially or completely obstructing esophageal cancer or endobronchial non-small cell lung cancer (NSCLC), for the treatment of inoperable microinvasive endobronchial NSCLC in patients not eligible for radiation therapy, and for the ablation of high-grade dysplasia in Barrett’s esophagus patients who do not undergo endoscopy.

All patients will develop photosensitivity after treatment and must observe precautions to avoid exposure of skin to direct sunlight or bright indoor light for at least 30 days after treatment.

Patients should also wear dark sunglasses for at least 30 days (or until ocular sensitivity resolves) when outdoors

Indications

1. Barrett’s esophagus
2. bladder cancer
3. esophageal cancer
4. non-small cell lung cancer (NSCLC)

For the treatment of esophageal cancer

NOTE: Porfimer has been designated by the FDA as an orphan drug for the treatment of esophageal cancer.

for the palliation of patients with completely obstructing esophageal cancer, or of patients with partially obstructing esophageal cancer who are unable to be satisfactorily treated with Nd:YAG laser therapy

Side Effects

1. abdominal pain
2. anemia
3. angina
4. anorexia
5. anxiety
6. asthenia
7. atrial fibrillation
8. back pain
9. bleeding
10. bradycardia
11. bronchospasm
12. candidiasis
13. cataracts
14. chest pain (unspecified)
15. confusion
16. constipation
17. cough
18. dehydration
19. diarrhea
20. diplopia
21. dizziness
22. dyspepsia
23. dysphagia
24. dysphonia
25. dyspnea
26. edema
27. eructation
28. erythema
29. esophageal stricture
30. esophageal ulceration
31. esophagitis
32. fever
33. GI perforation
34. heart failure
35. hematemesis
36. hemoptysis
37. hemoptysis
38. hiccups
39. hypertension
40. hypotension
41. ileus
42. infection
43. infusion-related reactions
44. insomnia
45. jaundice
46. laryngeal edema
47. melena
48. myocardial infarction
49. nausea
50. ocular pain
51. odynophagia
52. peptic ulcer
53. peripheral edema
54. pharyngitis
55. photophobia
56. photosensitivity
57. pleural effusion
58. pneumonitis
59. porphyria
60. pruritus
61. pulmonary edema
62. pulmonary embolism
63. pyrosis (heartburn)
64. respiratory arrest
65. sinus tachycardia
66. skin discoloration
67. stomatitis
68. stroke
69. supraventricular tachycardia (SVT)
70. thromboembolism
71. thrombosis
72. tissue necrosis
73. tracheoesophageal fistula
74. urticaria
75. vomiting
76. weight loss
77. wheezing

Monitoring Parameters

• pregnancy testing

Contraindications

• accidental exposure
• breast-feeding
• cardiac disease
• contraception requirements
• esophageal varices
• extravasation
• fistula
• hepatic disease
• male-mediated teratogenicity
• ocular exposure
• porphyria
• pregnancy
• pregnancy testing
• radiation therapy
• renal impairment
• reproductive risk
• requires an experienced clinician
• respiratory insufficiency
• sunlight (UV) exposure
• surgery
• thromboembolic disease

Interactions

• Acetohexamide
• Acitretin
• Adapalene
• Adapalene; Benzoyl Peroxide
• Alectinib
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
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• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Atenolol; Chlorthalidone
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Azilsartan; Chlorthalidone
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
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